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Domestic Violence Screening Tools

Learn more about domestic violence screening tools in health care settings.
© Coventry University. CC BY-NC 4.0

There are several ‘screening’ tools used in healthcare settings.

The HITS (see below) is an example of one such instrument, originally developed and validated for use in family practice clinics.

Scoring

Never: 1
Rarely: 2
Sometimes: 3
Fairly often: 4
Frequently: 5

Items

How often does your partner (Mnemonic: HITS):
Hurt
Physically hurt you (eg pushed, slapped, hit, kicked, punched)?
Insult
Insult or talk down to you?
Threaten
Threaten you with harm?
Scream
Scream or curse at you?

Interpretation

Total score: 4-20
Score >10 suggests presence of DVA

(Sherin et al., 1998)

Others include:

  • Women Abuse Screen Tool (WAST)
  • Abuse Assessment Screen (AAS)
  • Humiliation, Afraid, Rape and Kick (HARK)

For reviews of the above, see Arkins et al., 2016 and Rabin et al., 2009.

Screening tools can be helpful in designing clinical documentation and for research purposes. However, it is important to remember that effective listening, being non-judgmental and validating a person’s experiences are amongst the most powerful tools for supporting someone and promoting a healing journey in the context of DVA. Showing and interacting with diagrams of the body may also be useful in some cases (McMahon & Armstrong, 2012).

Given how language skills have been identified as a barrier to screening, professional interpreters should be available to assist in the screening process, which in turn should be done in a culturally-competent manner (Rodriguez et al., 1999).

Health settings can employ other approaches to enabling people to disclose abuse. In antenatal care, for example, non-verbal disclosure can be achieved by asking those experiencing DVA to place a spot on urine specimens. This can then prompt midwives trained to ask about DVA and to respond to disclosure to provide support.

References

Arkins, B., Begley, C., & Higgins, A. (2016). Measures for screening for intimate partner violence: A systematic review. Journal of Psychiatric and Mental Health Nursing, 23(3-4), 217-235. Web link

McMahon, S., & Armstrong, D. Y. (2012). Intimate partner violence during pregnancy: Best practices for social workers. Health & Social Work, 37(1), 9-17. DOI link

Rabin, R. F., Jennings, J. M., Campbell. J. C., & Bair-Merritt, M. H. (2009). Intimate partner violence screening tools: A systematic review. American Journal of Preventive Medicine, 36(5), 439-445. DOI link

Rodriguez, M. A., Bauer, H. M., McLoughlin, E., & Grumbach, K. (1999). Screening and intervention for intimate partner abuse: Practices and attitudes of primary care physicians. JAMA, 282(5), 468-474. Web link

Sherin, K. M., Sinacore, J. M., Li, X. Q., Zitter, R. E., & Shakil, A. (1998). HITS: A short domestic violence screening tool for use in a family practice setting. Family Medicine, 30(7), 508-512. Web link

© Coventry University. CC BY-NC 4.0
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Identifying and Responding to Domestic Violence and Abuse (DVA) in Pregnancy

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